The Affordable Care Act (ACA) requires that every State have a health insurance exchange (also called a “Marketplace”) in operation in 2014. A State may operate a Marketplace for individual consumers, small businesses or both. The Mississippi Insurance Department has decided to establish and operate a Health Insurance Marketplace for small businesses called One, Mississippi™. The Marketplace is an easy-to-use, easy-to-understand online tool that assists Mississippi’s small business owners interested in providing quality health insurance to their employees.

One, Mississippi is a one-stop shop where businesses with 2 to 50 full-time equivalent employees may choose from multiple, affordable health insurance options. An employer chooses one of four tiers and the employee chooses a plan in that tier. Employers also designate a contribution percentage toward the employee’s premium cost. Employees can use that contribution toward a health insurance plan that best fits their needs and budgets within the employer-selected tier.

Employers that meet certain qualifications may be eligible for a Small Business Health Insurance Tax Credit. The amount of the tax credit and what qualifications the employer must meet depend on which taxable year a small employer claims the credit. Some of the qualifications remain the same regardless of when the tax credit is claimed.

The eligibility requirements that small employers must meet are:

·Employ no more than twenty-five (25) full-time equivalent employees;

·Pay average annual wages below $50,000; and

·Pay a uniform percentage for all employees that is equal to at least fifty percent (50% of the premium cost of the individual health insurance for each employee.

One, Mississippi first opened for enrollment in May 2014 and after a short amount of time the Marketplace has already helped many small business owners in Mississippi acquire health coverage for their employees. Employers can enroll in the Marketplace online at www.onemississippi.com or through a licensed and certified insurance agent or broker. For more information, please call 1-855-9MS-SHOP or 1-855-967-7467.

“I have said all along that this is a commercial dispute between BCBS and HMA.Sometimes it is painful and takes time to resolve differences like these. We know from experience that when you give private markets time to work out their differences and grievances, these issues can be resolved without government interference. That has proven to be the case here and I am pleased.

Although the network matter has been resolved between the parties, the Insurance Department will issue our examination report addressing network adequacy in the very near future.”

The President announced today that the federal government would delay enforcement of the Affordable Care Act’s market reforms in 2014 for plans that are currently in effect.

In Mississippi we took steps several months ago to ensure that these reforms would have initial minimal impact on policyholders in our state. We allowed and encouraged the carriers to extend their plan years and coverage periods until December, 2014, allowing our citizens to keep their existing coverage with minimum rate increases and with more choices.

We do not expect that the President’s actions announced today will have any major impact on our state. However, it is quite possible that in the long run these reforms will have a major impact on the solvency of companies and might be a major cost to the industry, thus driving up prices over time. We will continue to closely follow any further developments to ensure we protect the interests of Mississippians.

Jackson – Mississippi senior citizens and Medicare recipients are today urged by Commissioner of Insurance Mike Chaney to carefully review the coverage and benefits of their policies during this year’s Medicare open enrollment period. Open enrollment for Medicare prescription drug coverage and Medicare Advantage runs from October 15-December 7, 2013.

During the Medicare annual enrollment period, all Medicare beneficiaries may change their Medicare coverage for the coming year. Beneficiaries should carefully investigate plan benefits and choices. New benefit choices will take effect January 1, 2014. Seniors seeking additional coverage through a Medicare supplement plan can get information in the 2013 Medicare Supplement Shoppers Guide now available on the MID website or by calling the Consumer Services division at 1-800-562-2957.

“It is also important for seniors to understand Medicare is NOT a part of the federal Health Insurance Marketplace and those who are receiving their health insurance benefits through Medicare will continue to do so rather than switch to the Health Insurance Marketplace,” Chaney said.

He added that if a senior purchases a plan through the Marketplace, they lose their Medicare coverage and are not eligible for the Marketplace subsidy. Also, depending on their situation, when the senior decides to leave the Marketplace, a late enrollment penalty for Medicare may apply. Regardless of whether a senior has Original Medicare or a Medicare Advantage Plan, the federal Marketplace will not affect coverage.

“During difficult economic times, making sure which plan is best for your budget and needs becomes extremely important,” Chaney said.

Chaney also reminds seniors that anyone using questionable or abusive sale practices when talking to you regarding your Medicare Advantage or prescription drug plan should be reported to the Mississippi Insurance Department.

State and federal rules are in place to protect consumers against sales and marketing abuses. Individuals who contact you about any type of private Medicare coverage:

•Must be licensed by the state. Check with the Mississippi Insurance Department to make sure the salesperson is a licensed agent.

•May not make unsolicited contact, such as door-to-door sales, cold calls or approaching you in a parking lot.

•Must make an appointment before coming to your home.

•Must arrange in advance the type of products that will be discussed during a scheduled sales appointment. At the appointment, the salesperson may not try to sell you other types of insurance coverage other than the type(s) agreed upon in advance.

•May not try to sell you non-health care related products (like a life insurance policy or an annuity) during a sales or marketing presentation of a Medicare prescription drug or Medicare Advantage plan.

•May not attempt to sell you a plan in certain health care settings, such as a doctor’s office or a pharmacy.

•May not attempt to sell you a plan at an educational event.

•May not offer you free meals at promotional or sales events.

To protect Mississippians from becoming victims of Medicare fraud, the MID reminds consumers of these safety tips.

•Beware of door-to-door sales people. Remember, agents cannot solicit business at your home without an appointment. Do not allow uninvited agents into your home.

•Do not give out personal information, such as Social Security numbers, bank account numbers or credit card numbers to anyone you have not verified as a licensed agent. People are not allowed to request such personal information in their marketing activities and cannot ask for payment over the Internet. They must send you a bill. Once you decide to purchase a plan and have verified that the agent is licensed, you may give the agent personal information to assist in enrollment and billing.

•Verify that the plan you have chosen is an approved Medicare plan. All of the approved plans are available at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).

Federal assistance is available to Medicare beneficiaries who meet certain income requirements. If you think you may qualify, call the Social Security Administration at 1-800-SSA-1213 (1-800-772-1213). For more information about your Medicare prescription drug options including an online Medicare Prescription Drug Plan Finder, go to www.medicare.gov.

Jackson, MS—Insurance Commissioner Mike Chaney and Attorney General Jim Hood are warning Mississippians to be aware of the con-artists that may emerge as federal and state agencies prepare for the Federal Facilitated Health Insurance Marketplace (FFM) rollout under the Affordable Care Act (ACA).

“We see scammers try to take advantage of such transitions, in this case hoping to take advantage of people who are not familiar with the nation’s new health care law,” said Attorney General Hood.

Starting today, if you are uninsured or buy your own coverage you can enroll for health insurance through the Federal Facilitated Health Insurance Marketplace for coverage beginning as soon as January 1, 2014.

“The Marketplace will allow you to compare and select plans,” said Commissioner Chaney.“Although enrollment opens on October 1, there is no need to rush out to purchase a plan, take your time, get as much information as you can before making a decision as to the plan that best suits you and your family’s needs. The federal government regulates and approves the plans for this marketplace. I would caution consumers purchasing through the FFM that they may be limited in their choice of medical providers based on the insurance company networks.”

Scammers Taking Advantage.

Unfortunately, scammers will undoubtedly attempt to take advantage of consumers once the Marketplace takes effect.In some cases, criminals will try to collect personal or financial information.In other cases, unscrupulous sales people will try to sell “discount medical plans.”Those so-called discount plans may be insurance plans that really don’t save you money, or they may not be legitimate health insurance plans at all.

Medicare is not part of Federal Facilitated Health Insurance Marketplace.

If you are a Medicare beneficiary, you don’t need to do anything—you are considered covered. The Marketplace won’t affect your Medicare choices, and your benefits will not change.

Tips to Avoid Scams.

1. The government will not call or email you to solicit enrollment plans.Your Marketplace options and additional information are available at www.HealthCare.gov or the Help Center at 1-800-318-2596.

2. Anyone who claims they’re enrolling you for coverage through the Marketplace should be verified by contacting www.HealthCare.gov or the Help Center at 1-800-318-2596.

3. Guard your personal information!If a caller claims they are with the government verifying personal information for a new government health insurance or Medicare card, hang up.(Medicare isn’t part of the Marketplace established by ACA, so you don't have to replace your Medicare coverage with Marketplace coverage.)The information they may seek could include Social Security numbers or bank account information for “direct deposits.”

4. Be wary of sound-alike government or company names, especially if they list a toll-free number other than the Help Center’s number (1-800-318-2596).

Legitimate Sources for Information & Coverage Enrollment.

You can learn more about qualified health plans offer in Mississippi through the FFM through several sources:

Website:www.HealthCare.gov: This is the federal government’s official FFM website.Here you can now get information, compare plans and coverage options, and you can enroll starting October 1.

Help Center: 1-800-318-2596: The Help Center is now open 24 hours a day, seven days a week.You can talk with a customer service representative, obtain the same information you’ll find on the website, and you can enroll for coverage starting October 1.

Navigators: Navigators, who are government trained and certified, will help answer Marketplace questions, discuss eligibility and options, and prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplace.On October 1, you’ll find Mississippi Navigators through the federal government’s website or Help Center (see above).In Mississippi, there are only two approved Navigators:Universtiy of Mississippi Medical Center (Jackson, MS) and Oak Hill Missionary Baptist Church Ministries, Inc. (Hernando, MS).

Certified Application Counselors: These counselors will perform many of the same functions as navigators, including educating consumers and helping people complete applications for coverage.Counselors might come from community health centers or other health care providers, hospitals or social service agencies.On October 1, you’ll find Certified Application Counselors through the federal government’s website or Help Center.

For more information on this topic, go to www.HealthCare.gov or the Federal Help Center at 1-800-318-2596. Additional information may also be obtained at the Mississippi Insurance Department’s website:www.mid.ms.gov.To file a complaint regarding a possible scam, contact the Consumer Protection Division of the Mississippi Attorney General’s Office by calling 601-359-4230 or 1-800-281-4418.

On August 28, 2013, the United States Department of Health and Human Services issued regulations that will now allow states to apply to operate a state-based free market Small Business Health Options Program (SHOP) marketplace.

“Mississippi is in a position to begin operation of a free market SHOP marketplace in the first quarter of 2014,” Commissioner of Insurance Mike Chaney said.

Chaney stressed that a SHOP marketplace is not an ObamaCare state exchange for subsidized beneficiaries and does not expand Medicaid. He also noted that the Mississippi State Senate passed a bill to create such a marketplace before ObamaCare was proposed.

Mississippi has applied to operate a SHOP marketplace. The Mississippi Insurance Department recognizes the importance of providing small business owners access to alternative health care options for their employees and is committed to facilitating the establishment of a state-based Small Business Health Options Program (SHOP)-only Marketplace.

“The state has had a developed plan ready since early 2013 and has been waiting for Federal approval of our request to operate the free market approach of SHOP exchanges. I am pleased that Federal authorization was granted by CCIIO August 28th, 2013 for all states to apply to operate a state based free market SHOP, “Chaney said.

(*Note-CCIIO-The Center for Consumer Information and Insurance Oversight within HHS)

A SHOP Marketplace is designed to assist employers and facilitate enrollment of employees into qualified health plans (QHPs). Small employers, primarily those with fewer than fifty (50) eligible employees, will be able to apply and enroll online in an array of QHPs. The SHOP Marketplace will offer a flexible and easy-to-understand plan selection process for both employers and employees, and will include services for premium billing and payment processing, among others.

"It is with great gratitude and thanks that MID and I make this announcement that affects the citizens of our great state." - Commissioner Mike Chaney

Through the efforts of many individuals, we are pleased to announce that Humana has stepped forward to cover the 36 counties in Mississippi that did not have health plans available under the Federally facilitated Health Insurance Marketplace. As many people know, we have had real concerns about being able to have full coverage for the entire state. Humana’s decision to extend their coverage in Mississippi demonstrates their good corporate citizenship. We appreciate both Humana and Magnolia Health Plan’s work to cover all counties in the state on behalf of our citizens.

Humana has released the following statement:

“Humana filed to amend our qualified health plans offered on the individual exchange in Mississippi to include an additional 36 counties (for a total of 40 counties). The additional counties represent those that we recently learned would otherwise have had no individual exchange offerings – thus, no subsidy-eligible coverage options for qualifying residents. This builds on Humana’s current presence in the state of Mississippi, where Humana already covers well over 200,000 Mississippians, including individuals, employer groups, military retirees and their families, as well as Medicare beneficiaries. By working together with local health care providers, we believe we can enhance quality of care and improve health outcomes in the state. Humana’s goal is to help people achieve lifelong well-being.”

I am very pleased to announce that I have been informed that University Medical Center and Blue Cross-Blue Shield of Mississippi have agreed to continue their relationship by signing a new Network Provider agreement today. I commend Blue Cross and UMC for their diligent efforts in reaching this agreement.

This new agreement will allow Blue Cross to continue to partner with UMC in managing healthcare costs for Mississippians. It will also ensure that consumers in Mississippi and throughout the United States have continued affordable access to some of the finest medical care available from a premier medical research facility.

Welcome to Mississippi’s Rate Review Website. I am very excited about the launch of this site and hope that you will find it to be a useful tool for learning about health insurance rates and researching rate information regarding your insurance plans. On this site you will find rate information for major medical policies, specified disease policies, long term care policies, disability insurance policies and Medicare Supplement policies.

One question that I am constantly asked is “why do my insurance rates continue to rise?” As both a regulator and a consumer I am sensitive to and frustrated by the continued need for rate increases that seem to get larger and larger. Unfortunately, the truth is that I have little more control over rate increases than the average consumer does. These increases are typically based on factors beyond which any of us have any direct control. These factors include the rising costs of medical care, inflation and changes in state and federal law. Up until now there have been few resources for consumers to use that allow them direct access to the information used to determine rates.

The purpose of this site is to provide consumers with a transparent and comprehensive educational resource regarding health insurance premiums. My hope is that consumers will use this site to help understand how premium rates are set and what factors contribute to rate changes. Once consumers are armed with this information, they can use it to make efforts that will hopefully one day stabilize the escalating costs of healthcare in this country and lower the rates we all pay for health insurance.

I invite you to please explore our site and do not hesitate to contact us if you have any comments or questions. This site is a resource for you and is a work in progress so I invite any suggestions that you may have.